Healthcare Provider Details

I. General information

NPI: 1194251066
Provider Name (Legal Business Name): MICHAEL JAMES BAUSCHARD M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ANMED HEALTH 800 N. FANT ST
ANDERSON SC
29621
US

IV. Provider business mailing address

ANMED HEALTH 800 N. FANT ST
ANDERSON SC
29621
US

V. Phone/Fax

Practice location:
  • Phone: 864-512-1000
  • Fax: 864-716-7769
Mailing address:
  • Phone: 864-512-1000
  • Fax: 864-716-7769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberNOT AVAILABLE YET
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: